title: Prevalence, characteristics, and management of childhood functional abdominal pain in general practice.
abstract: OBJECTIVE
  To (i) describe the proportion of children presenting with abdominal pain diagnosed by the GP as functional abdominal pain (GPFAP); (ii) evaluate the association between patient and disease characteristics and GPFAP; (iii) describe diagnostic management by the GP in children presenting with abdominal pain, and (iv) evaluate whether children with GPFAP fulfill diagnostic criteria for functional abdominal pain (FAP) as described in current literature: chronic abdominal pain (CAP) and the Rome III criteria (PRC-III) for abdominal pain-related functional gastrointestinal disorders (FGID).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  General practices in the Netherlands.
  
  
  METHODS
  305 children aged 4-17 years consulting for abdominal pain.
  
  
  METHODS
  GPFAP, CAP, FGIDs.
  
  
  RESULTS
  89.2% of children were diagnosed with GPFAP. Headaches and bloating were positively associated with GPFAP whereas fever and > 3 red flag symptoms were inversely associated. Additional diagnostic tests were performed in 26.8% of children. Less than 50% of all children with GPFAP fulfilled criteria for CAP and FGIDs; in 47.9% of patients the duration of symptoms at presentation was less than three months.
  
  
  CONCLUSIONS
  In almost 90% of children included in this study the GP suspected no organic cause for the abdominal pain. GPs diagnose FAP in children without alarm symptoms and order diagnostic testing in one out of four children presenting with abdominal pain. No difference was found in GPs' management between children with a diagnosis of GPFAP and other diagnoses. Only about half of the children with a GP diagnosis of FAP fulfilled time-criteria of FAP as defined in the literature.
authors.affiliation: Department of General Practice, Erasmus MC University Medical Centre , Rotterdam , the Netherlands.
authors.forename: Leo A A
authors.initials: LA
authors.lastname: Spee
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lisman-Van Leeuwen
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D058006:General Practice; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence